ISSN:0007-1323    

DOI:10.1002/bjs.1800700202

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800700203

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractThis study summarizes our experience with the use of 15 superior and inferior rectus abdominis myocutaneous flaps for filling defects in the chest wall, pectoral region, abdominal wall and groin. An extension of this flap above the costal margin, recommended in the study, provides valuable additional tissue. The flap is reliable and easily constructed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800700204

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractThe use of 30 rectus abdominis flaps in patients with breast cancer is described. In 7 patients the flap has been used to repair the defect following ablation of recurrent disease or radionecrotic ulcers. In the remaining 23 the flap has been used as part of a primary reconstruction at the time of mastectomy. The technique is described together with the results in these patients. The cosmetic results have been satisfactory. The technique as described has proved completely reliable. Follow‐up to 18 months has shown that fears of incisional hernias developing are unfounde

ISSN:0007-1323    

DOI:10.1002/bjs.1800700205

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractOne hundred and forty patients with undiagnosed severe chronic abdominal pain who had not undergone previous biliary surgery were investigated by ERCP. A diagnosis was achieved in 34 patients (24 per cent) including 8 with previously undiagnosed peptic ulceration and 5 with gallstones. Twenty‐five patients (18 per cent) had an abnormal pancreatogram, including 1 with pancreatic cancer. The incidence of pancreatogram abnormalities suggestive or diagnostic of pancreatitis was particularly high (60 per cent) in patients with a history of alcohol abuse. ERCP has a valuable role in the investigation of patients with ‘obscure’ abdominal

ISSN:0007-1323    

DOI:10.1002/bjs.1800700206

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractDieulafoy's disease is a distinctive arteriovenous malformation of the gastric fundus, which presents with massive or recurrent gastrointestinal bleeding. The lesion is very small and easily overlooked even at laparotomy, and can only be correctly diagnosed by endoscopy or arteriography if the patient is actively bleeding. A wedge resection will stop bleeding and give histological confirmation of the characteristic submucosal vessels.

ISSN:0007-1323    

DOI:10.1002/bjs.1800700207

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractTwenty patients undergoing major surgical procedures received constant infusion (2 l/day) of either 3·5 per cent amino acid (AA) or 5 per cent dextrose (D5W) solutions in addition to other fluid requirements for 4 postoperative days. Ketosis was evident in A A patients as a mean daily β‐hydroxy butyrate excretion of 2·16 ± 1·39 mmol and respiratory quotient of 0·708 ± 0·013 compared with 0·28 ± 0·45 mmol/day and 0·754 ± 0·015 respectively in the D5W group. The serum total protein and albumin concentrations (but not those of transferrin and prealbumin) were significantly higher in the A A than the D5W group on day 4. However, the mean fluid balance for days 3 and 4 was significantly less positive in AA patients. The mean daily nitrogen balance of −6·6 ± 7·7 gN/day in A A patients and −9·5 ± 5·8 gN/day in D5W patients was not significantly different. Mean daily 3‐methyl histidine excretion (38·2 ± 12·3 μmol/mmol creatinine) in A A patients was significantly higher than in D5W patients (31·2 ± 10·8 μmol/mmol creatinine). With no improvement in nitrogen balance, an increase in muscle protein breakdown and the possibility that decreased fluid retention explains the higher serum total protein and albumin levels, this study fails to demonstrate improved protein sparing by isotonic ami

ISSN:0007-1323    

DOI:10.1002/bjs.1800700208

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800700209

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractPTFE (Goretex) and modified human umbilical vein (Biograft) vascular grafts were compared in femorodistal popliteal artery bypass surgery in a randomized clinical multicentre trial. During 18 months 104 patients (104 limbs) entered the trial. Twenty‐five patients suffered from claudication, 54 suffered rest pain and 25 patients had ulceration or gangrene. The median preoperative ankle–arm blood pressure index was 0·34. Twenty‐three limbs had 3 patent tibial arteries, 45 limbs had 2 tibial arteries, 31 limbs had 1 tibial artery while 5 limbs had an isolated popliteal segment. Thirty‐six of the operations were redo‐operations. Fifty‐four patients were allocated to PTFE and 50 to umbilical vein. During follow‐up (maximum 650 days) 24 PTFE grafts occluded against 12 umbilical veins. The 1‐year patency rate was 40 per cent in the PTFE group against 75 per cent in the umbilical vein group (P = 0·014, Gehans test). During the first year the PTFE failure rate was on average 3·1 times higher than that of

ISSN:0007-1323    

DOI:10.1002/bjs.1800700210

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractUreteric peristalsis has been studied using extraluminal bipolar electrodes and metal foil strain gauges in both the unanaesthetized and anaesthetized dog. Electrical activity of the ureter was characterized by bipolar action potentials, which always preceded mechanical activity. In the acute studies glucagon 44 μg/kg i.v. was given during the unstimulated phase and again during a forced diuresis. Complete inhibition of ureteric activity was seen for 19·50 ( ± 3·76 s.e.) and 16·25 ( ± 1·59 s.e.) min respectively. During this period there was no change in the rate of urine flow.In the conscious dog glucagon was given as a bolus of 22 μg/kg followed by an infusion for 45 min. An infusion of 88 μg/kg h produced complete inhibition for 39·2 ( ± 2·41 s.e.) min. Propantheline, hyoscine, morphine, pethidine and buprenorphine were given in equivalent therapeutic human doses, but no consistent effect on ureteric peristalsis was seen. Glucagon may have a role to play in the management of ure

ISSN:0007-1323    

DOI:10.1002/bjs.1800700211

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY